What is the Optimal Method for Steroid Delivery in the Treatment of Chronic Rhinosinusitis With Nasal Polyps?

홍승노,김동영 대한천식알레르기학회 2019 Allergy, Asthma & Immunology Research Vol.11 No.4

한국인에서 호산구성 중이염의 청력학적 및 임상적 고찰

홍승노,박하나로,정주용,서명환,이준호,장선오,오승하 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.11

Background and Objectives Eosinophilic otitis media (EOM) is characterized by the presence of a highly viscous effusion containing eosinophils. It mainly occurs in patients with bronchial asthma, nasal polyps and is resistant to conventional treatments for otitis media. In these patients, steroid is very effective in controlling the disease. However, the major complication is sensorineural hearing loss, especially at high frequencies, which may occur despite steroid therapy. Subjects and Method Here we report 10 cases of EOM at Seoul National University Hospital. Clinical courses and characteristics of the patients were analyzed. We compared the hearing deterioration and other clinical variables between EOM patients and age-matched non-EOM chronic otitis media patients. Results All cases had viscous effusion and 9 cases were associated with asthma and nasal polyps. All patients had a decreased hearing in high frequency range compared to the age matched controls. The average bone conduction threshold difference at 2 kHz, 4 kHz was 22.4dB HL and 42.5 dB HL, respectively. Among the patients, one showed profound sensorineural hearing loss bilaterally after the onset of EOM and received cochlear implantation. The open set sentence score was 82% 6 months after cochlear implantation. Most of the cases were resistant to conventional treatments for otitis media, such as administration of antibiotic agents,ventilation tube insertion or mastoidectomy. However, cases that were given steroid treatment had improvement in ear symptoms. Conclusion Since EOM patients show deterioration of hearing, it is important to properly diagnose EOM, start adequate treatment and explain to patients that the disease may last for a long period and progressive hearing loss may occur.

비강 점막의 활성 산소, 인터페론 그리고 항바이러스 선천성 면역반응

홍승노,김현직 대한이비인후과학회 2015 대한이비인후과학회지 두경부외과학 Vol.58 No.11

The regulated production of reactive oxygen species (ROS) has been considered a unique property of phagocytic cells which use this ROS system to induce innate defense system that enables it to successfully combat the pathogens. However, the mechanisms for how respiratory mucosa might produce ROS against respiratory viral infection still need to be completely defined. Respiratory mucosa and nasal epithelium has been known as the first defense site of human respiratory tract which is highly exposed and vulnerable to environmental pathogens, including air-bone microbes, viruses and allergens. We are especially interested in the innate immune response to respiratory virus infection in nasal epithelium and how this response might be influenced by ROS generation after viral infection. The interferon (IFN) signaling system is perhaps the most critical pathway for antiviral defense and protective actions of IFNs rely on signaling through IFN receptors, transcription factors and IFN-stimulated genes or antiviral cytokines requiring for virus degradation and suppression of viral transcription or translation. We verified that both type I and type III IFN genes expression and secreted proteins were more highly induced after influenza A virus infection in nasal epithelium. We also propose that type III IFNs are the primary IFNs to mediate an anti-viral defense in nasal epithelium and more sensitively reacted with ROS which were produced after respiratory virus infection. We estimate that ROS are necessary for the innate immune response and trigger the induction of IFN-related innate immune response to resist respiratory virus infection in human respiratory mucosa.

경막외 농양이 합병된 급성 유양돌기염 1예

홍승노,김영호,김종선 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.8

Epidural abscess is the most common intracranial complication of acute mastoiditis and may lead to a life-threatening condition if an appropriate treatment is not performed. The treatment of choice is a surgical eradication of lesion, drainage of the abscess, and intravenous antibiotic therapy. We report a case of acute mastoiditis followed by an epidural abscess in the posterior cranial fossa in a 32-month male patient.

만성 비부비동염의 표현형에 따른 올바른 약물 치료

홍승노 ( Seung No Hong ),김대우 ( Dae Woo Kim ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.3

Chronic rhinosinusitis is generally divided into 2 types. One is chronic rhinosinusitis with nasal polyps and the other is chronic rhinosinusitis without nasal polyps. However, this classification has the drawbacks no consideration of various immunologic characters of chronic rhinosinusitis and too simple grouping. To compensate for these drawbacks, 1 recent classification has utilized histologic and immunologic parameters to subdivide chronic rhinosinusitis with nasal polyps into that with eosinophilic polyps and that with noneosinophilic nasal polyps. Moreover, phenotyping of chronic rhinosinusitis by using various clinical parameters such as biopsy, computed tomography, and endoscopic findings is very important for the appropriate medical treatment. In this review, before discussing the overall medical treatment of chronic rhinosinusitis, we describe not only clinical characters of chronic rhinosinusitis without nasal polyps but also the immunologic and histologic differentiation of chronic rhinosinusitis cases with eosinophilic and noneosinophilic nasal polyps closely related to the phenotype of chronic rhinosinusitis.(Allergy Asthma Respir Dis 2015;3:167-172)

만성 비부비동염과 알레르기비염에서 마이크로바이옴 연구

홍승노 ( Seung-no Hong ),박보나 ( Pona Park ),조상헌 ( Sang-heon Cho ),김동영 ( Dong-young Kim ) 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.6

The human microbiome is a collection of microbial species and their associated genomes that live on and in the body. Recent advances in molecular biology methods have revolutionized microbiome analysis techniques. Studies of the airway microbiome have illustrated that the paranasal sinuses are not sterile in the healthy state. Because human airways are in constant contact with the external environment and their mucosal surfaces are colonized with microorganisms, it is assumed that the local microbiota might influence immune homeostasis as well. Chronic rhinosinusitis and allergic rhinitis are the most common chronic airway diseases that yield a significant amount of socioeconomic burden. Despite the problematic nature of the diseases, a thorough understanding of their cause and pathogenesis is still lacking. At present, bacteria are believed to play a pathogenetic role in the propagation of inflammation and it is necessary to establish the relationship between the microbiome and inflammatory patterns to find their clinical reflections and also their possible causal relationship. Such investigations may elucidate the path to therapeutic approaches in correcting an imbalanced microbiome. In this review, we summarized recent typical studies dealing with the upper airway microbiome and discuss their clinical significance focusing on chronic rhinosinusitis and allergic rhinitis. (Allergy Asthma Respir Dis 2016:4:399-405)

성인 인공와우이식 환자의 수술전 전정기능: 언어습득 여부에 따른 비교

한재준,홍승노,박하나로,구자원,이준호,오승하,장선오,이민영,서명환 대한이비인후과학회 2014 대한이비인후과학회지 두경부외과학 Vol.57 No.2

Background and Objectives Cochlear system and vestibular system have close relationship anatomically and developmentally. According to previous literatures, there are high incidences of vestibular dysfunction in subjects with severe hearing loss. The aim of this study is to validate the status of vestibular function in adults with profound hearing loss, and to compare the status of vestibular function between pre-lingual and post-lingual deaf. Subjects and Method Vestibular function of 59 patients who had profound hearing loss was reviewed retrospectively. Patient’s information and audiometry, Korean version Central Institute for the Deaf (KCID) scores, caloric test, rotation chair test and vestibular evoked myogenic potential (VEMP) were analyzed. The subjects were divided into two groups, prelingual deaf (pre-LD, n=12) and postlingual deaf (post-LD, n=47). We analyzed the difference between two groups. Results Fifty nine point six percent of patients showed hypo-function in caloric test. In the rotational chair test, abnormality of step velocity gain (43.1%), time constant (51.8%), sinusoidal harmonic acceleration (SHA)-gain (53.4%), SHA-phase lead (29.1%) and SHA-asymmetry (23.6%) were found. There was unilateral (20.0%) and bilateral (37.5%) hypo-function when VEMP was tested. Between pre-LD and post-LD groups, VEMP test revealed statistically significant difference between two groups (p=0.020). Post-LD groups had more patients of unilateral or bilateral hypofunction in VEMP test. The KCID score showed no significant correlation with vestibular functions. Conclusion The patients of bilateral profound hearing loss showed unilateral or bilateral vestibular functional abnormality despite of no dizziness. Prevalence of lateral canal dysfunction does not seem to be different between pre-LD group and post-LD group. And post-LD groups have higher probability of saccular dysfunction than pre-LD. Korean J Otorhinolaryngol-Head Neck Surg 2014;57:89-95

고도비만이 동반된 폐쇄성수면무호흡증 환자에서 시행된 비만대사수술 1례

이상국,홍승노,정재현,최지호,Lee, Sang Kuk,Hong, Seung-No,Jung, Jae Hyun,Choi, Ji Ho 대한수면의학회 2016 수면·정신생리 Vol.23 No.2

Obstructive sleep apnea syndrome (OSAS) has negative effects on health, including increased mortality, risk of cardiovascular disease, and neurocognitive difficulties. OSAS is common in obese patients and obesity is an important risk factor of OSAS. A 41-year-old female OSAS patient with severe obesity (body mass index [BMI] ${\geq}35$) who failed dietary weight loss underwent bariatric surgery. After surgery, there were improvements in BMI (from 36.9 to $31.7kg/m^2$) and polysomnographic data, including the apnea-hypopnea index (from 25.1 to 11.2 events/hr) and minimum SaO2 (from 69 to 82%). This case demonstrates that bariatric surgery may be an effective therapeutic option to reduce sleep-disordered breathing in severely obese patients with moderate OSAS. Bariatric surgery as a treatment option for OSAS should be considered in OSAS patients with severe obesity who failed dietary weight loss.

Complications After Inadequate Treatment of Nasal Bone Fracture Combined With Septal Fracture: A Case Report

양승구,홍승노 대한비과학회 2021 Journal of rhinology Vol.28 No.3

In treating a nasal bone, an incomplete nasal bone reduction can result in nasal deformity, both aesthetic and functional, requiring a secondary operation. A 60-year-old female with a traumatic comminuted nasal bone fracture with septal fracture was initially treated with closed reduction, which later resulted in a saddle nose and a completely occluded nasal cavity. Later, the patient underwent a revision operation of extracorporeal septorhinoplasty with rib cartilage graft, and the postoperative course was uneventful. Herein, we present a case of complications occurring after inadequate treatment of septal fracture. Physicians should thoroughly evaluate the extent of the nasal bone fracture, including the integrity of the nasal septum, and manage accordingly In treating a nasal bone, an incomplete nasal bone reduction can result in nasal deformity, both aesthetic and functional, requiring a secondary operation. A 60-year-old female with a traumatic comminuted nasal bone fracture with septal fracture was initially treated with closed reduction, which later resulted in a saddle nose and a completely occluded nasal cavity. Later, the patient underwent a revision operation of extracorporeal septorhinoplasty with rib cartilage graft, and the postoperative course was uneventful. Herein, we present a case of complications occurring after inadequate treatment of septal fracture. Physicians should thoroughly evaluate the extent of the nasal bone fracture, including the integrity of the nasal septum, and manage accordingly.

Determinants of Conductive Hearing Loss in Tympanic Membrane Perforation

박하나로,홍승노,김효상,한재준,정주용,서명환,오승하,장선오,이준호 대한이비인후과학회 2015 Clinical and Experimental Otorhinolaryngology Vol.8 No.2

Objectives. Tympanic membrane perforations are common, but there have been few studies of the factors determining the extent of the resulting conductive hearing loss. The aims of this study were to determine whether the size of tympanic membrane perforation, pneumatization of middle ear & mastoid cavity, and location of perforation were correlated with air-bone gap (ABG) of patients. Methods. Forty-two patients who underwent tympanoplasty type I or myringoplasty were included and preoperative audiometry were analyzed. Digital image processing was applied in computed tomography for the estimation of middle ear & mastoid pneumatization volume and tympanic membrane photograph for the evaluation of perforation size and location. Results. Preoperative mean ABG increased with perforation size (P=0.018), and correlated inversely with the middle ear & mastoid volume (P=0.005). However, perforations in anterior versus posterior locations showed no significant differences in mean ABG (P=0.924). Conclusion. The degree of conductive hearing loss resulting from a tympanic membrane perforation would be expected with the size of perforation and pneumatization of middle ear and mastoid.